Individual
DR. DERRICK OLIVER CLUNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13535 NEMOURS PKWY, NEMOURS CHILDRENS HOSPITAL, ORLANDO, FL 32827-7402
(407) 567-4000
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2021012259
MO
208000000X
Pediatrics Physician
ME78560
FL
208M00000X
Hospitalist Physician
ME78560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257755100
—
FL
Enumeration date
12/20/2005
Last updated
07/07/2021
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